Provider Demographics
NPI:1083178602
Name:OKEKE, PHILIP ONYEDIKACHI
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:ONYEDIKACHI
Last Name:OKEKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 HAZELWOOD TER
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3304
Mailing Address - Country:US
Mailing Address - Phone:908-315-6428
Mailing Address - Fax:
Practice Address - Street 1:1020 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3309
Practice Address - Country:US
Practice Address - Phone:908-315-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03985000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist